The TLV’s review of antidepressants puts price pressure on pharmaceutical companies

Today the TLV is presenting its review of reimbursed medicines used for treating depression. The review releases approximately 40 million Swedish crowns on an annual basis and has exerted price pressure on companies selling expensive medicines where alternatives have been available with the same substances at a fraction of the price. This has led to a number of companies more than halving their prices on some medicines.

Antidepressants turn over almost 1 billion Swedish crowns each year, and the State reimburses to the value of 700 million Swedish crowns per year. The TLV’s review of prescription drugs used for treating depression will free up approximately 40 million Skr per year, money which can be used for other urgent areas within the healthcare system.

A large part of the money saved comes from pharmaceutical companies decreasing their prices. The price for the medicine called Zoloft has been decreased from 9 Skr per tablet to 3 Skr, and the medicine Cipramil from almost 8 Skr per tablet to 3 Skr. The expensive brand name drugs whose prices have not been decreased lose their reimbursement status and are therefore removed from the reimbursement system.
– Our objective is to extract as much health as possible for tax money which is utilised on medicines. For this reason the active substance fluvoxamine, in the medicine Fevarin, is disappearing from the high-costs threshold. The medical effect obtained does not measure up to price, says Ann-Christin Tauberman, Director General at the TLV, Dental and Pharmaceutical Benefits Agency.

One of the conclusions reached in the review is that many patients need to try different medicines in order to achieve the desired effect. A broad range of antidepressant medicines are therefore needed within the high cost threshold.
– Not even half of the patients achieve a satisfactory outcome from their first treatment. And for this reason more effective medicines are needed for treating depression and also more knowledge on how they should be applied, says Ann-Christin Tauberman.

Depression-related conditions are one of the most common causes of illness and the inability to work. Around 700 000 Swedes were treated during 2007 using antidepressants. The societal costs for depression-related illnesses amount to approximately 40 billion Skr per year.

Medicines against depression is the fifth therapeutic group from a total of 49 therapeutic groups to be reviewed. The decisions come into effect on the 1st of April, 2009. The next pharmaceutical review to be presented is medicines against high cholesterol. Previously we have reviewed drugs for stomach acid diseases, migraine, asthma, coughing and COPD as well as hypertension.

The entire list of medicines included in the reviews is available at på www.tlv.se/depression. You can also find the report in its entirety at this web address.

For further information please contact:
Ann-Christin Tauberman, Director General, tel: +46 8 568 420 51
Cecilia Hultin, acting Head of Communications, tel: +46 8 568 420 88

The Dental and Pharmaceutical Benefits Agency’s (TLV) main remit is to decide which dental treatments, medicines and medical devices shall be reimbursed by society. Dental care is reimbursed at 6 billion Skr per year. Medicine and medical devices were reimbursed at almost 20 billion Skr in 2007.

Brief facts on depression

• 700 000 Swedes took antidepressants in 2007.
• During 2007 antidepressants were sold to a value of 1 billion Skr, of which the State reimbursed 660 million Skr.
• Depression-related conditions are one of the greatest causes of illness and the inability to work.
• Other conditions counted as depression-related are anxiety-related illnesses such as phobias, panic attacks, obsessive thoughts and obsessive actions
• The total societal cost for depression-related conditions was 40 billion Swedish crowns for 2007.
• Societal costs for depression-related illnesses doubled between 1997 and 2007.

Source: The TLV’s report on the review of antidepressants

Original brand drugs decreasing their prices due to the review

(these examples indicate the most popular strength in the 100 tablet package size or its equivalent during the period October 2007–March 2008)

• Zoloft, 50 mg, 98 tablets per package. From 9.23 Skr per tablet to 3 Skr per tablet
• Cipramil, 20 mg, 98 tablets per package. From 7.83 Skr per tablet to 3 Skr per tablet
• Aurorix, 50 mg, 100 tablets per package. From 3.53 Skr per tablet to 3 Skr per tablet.

Medicines losing their reimbursement status

• Fevarin (fluvoxamine will be removed from the high cost threshold on 1st of April, 2009)
• Remeron-S (generic mirtazapine will remain in the high-cost threshold)
• Fontex (the active substance fluoxetine will remain in the high cost threshold)
• Seroxat (the active substance paroxetine will remain in the high cost threshold)

Facts in brief on the high-cost threshold

Today the TLV is presenting its review of reimbursed medicines used for treating depression. The review releases approximately 40 million Swedish crowns on an annual basis and has exerted price pressure on companies selling expensive medicines where alternatives have been available with the same substances at a fraction of the price. This has led to a number of companies more than halving their prices on some medicines.

Antidepressants turn over almost 1 billion Swedish crowns each year, and the State reimburses to the value of 700 million Swedish crowns per year. The TLV’s review of prescription drugs used for treating depression will free up approximately 40 million Skr per year, money which can be used for other urgent areas within the healthcare system.